PMID- 36966073
OWN - NLM
STAT- Publisher
LR  - 20231016
IS  - 1878-4046 (Electronic)
IS  - 1076-6332 (Print)
IS  - 1076-6332 (Linking)
VI  - 30
IP  - 11
DP  - 2023 Nov
TI  - Distribution of Aeration and Pulmonary Blood Volume in Healthy, ARDS and COVID-19 
      Lungs: A Dual-Energy Computed Tomography Retrospective Cohort Study.
PG  - 2548-2556
LID - S1076-6332(23)00032-6 [pii]
LID - 10.1016/j.acra.2023.01.016 [doi]
AB  - RATIONALE AND OBJECTIVES: Few reports have studied lung aeration and perfusion in 
      normal lungs, COVID-19, and ARDS from other causes (NC-ARDS) using dual-energy 
      computed tomography pulmonary angiograms (DE-CTPA). To describe lung aeration and 
      blood-volume distribution using DE-CTPAs of patients with NC-ARDS, COVID-19, and 
      controls with a normal DE-CTPA ("healthy lungs"). We hypothesized that each of 
      these conditions has unique ranges of aeration and pulmonary blood volumes. 
      MATERIALS AND METHODS: This retrospective, single-center study of DE-CTPAs 
      included patients with COVID-19, NC-ARDS (Berlin criteria), and controls. 
      Patients with macroscopic pulmonary embolisms were excluded. The outcomes studied 
      were the (1) lung blood-volume in areas with different aeration levels (normal, 
      ground glass opacities [GGO], consolidated lung) and (2) aeration/blood-volume 
      ratios. RESULTS: Included were 20 patients with COVID-19 (10 milds, 10 
      moderate-severe), six with NC-ARDS, and 12 healthy-controls. Lung aeration was 
      lowest in patients with severe COVID-19 24% (IQR13%-31%) followed by those with 
      NC-ARDS 40%(IQR21%-46%). Blood-volume in GGO was lowest in patients with COVID-19 
      [moderate-severe:-28.6 (IQR-33.1-23.2); mild: -30.1 (IQR-33.3-23.4)] and highest 
      in normally aerated areas in NC-ARDS -37.4 (IQR-52.5-30.2-) and moderate-severe 
      COVID-19 -33.5(IQR-44.2-28.5). The median aeration/blood-volume ratio was lowest 
      in severe COVID-19 but some values overlapped with those observed among patients 
      with NC-ARDS. CONCLUSION: Severe COVID-19 disease is associated with low total 
      aerated lung volume and blood-volume in areas with GGO and overall aeration/blood 
      volume ratios, and with high blood volume in normal lung areas. In this 
      hypothesis-generating study, these findings were most pronounced in severe COVID 
      disease. Larger studies are needed to confirm these preliminary findings.
CI  - Copyright (c) 2023 The Association of University Radiologists. Published by 
      Elsevier Inc. All rights reserved.
FAU - Bogot, Naama R
AU  - Bogot NR
AD  - Department of Radiology(,) Jerusalem, Israel.
FAU - Steiner, Roee
AU  - Steiner R
AD  - Nuclear Medicine and PET, Jerusalem, Israel.
FAU - Helviz, Yigal
AU  - Helviz Y
AD  - The Intensive Care Unit, Jerusalem, Israel; The Shaare Zedek Medical Center, 
      Hebrew University Faculty of Medicine, Samuel Byte 12, Jerusalem, Israel.
FAU - Weiss, Chedva
AU  - Weiss C
AD  - The Intensive Care Unit, Jerusalem, Israel; Department of pediatrics, Hadassah 
      Medical Center Jerusalem, Jerusalem, Israel.
FAU - Cherniavsky, Konstantin
AU  - Cherniavsky K
AD  - Department of Radiology(,) Jerusalem, Israel.
FAU - Pichkhadze, Olga
AU  - Pichkhadze O
AD  - Department of Radiology(,) Jerusalem, Israel.
FAU - Ball, Lorenzo
AU  - Ball L
AD  - The Department of Surgical Sciences and Integrated Diagnostics (DISC), University 
      of Genoa, Genoa, Italy; Anesthesia and Intensive Care, San Martino Policlinico 
      Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy.
FAU - Frank, Yigal
AU  - Frank Y
AD  - Department of Radiology(,) Jerusalem, Israel.
FAU - Levin, Philip
AU  - Levin P
AD  - The Intensive Care Unit, Jerusalem, Israel; The Shaare Zedek Medical Center, 
      Hebrew University Faculty of Medicine, Samuel Byte 12, Jerusalem, Israel.
FAU - Pelosi, Paolo
AU  - Pelosi P
AD  - The Department of Surgical Sciences and Integrated Diagnostics (DISC), University 
      of Genoa, Genoa, Italy; Anesthesia and Intensive Care, San Martino Policlinico 
      Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy.
FAU - Benjaminov, Ofer
AU  - Benjaminov O
AD  - Department of Radiology(,) Jerusalem, Israel.
FAU - Einav, Sharon
AU  - Einav S
AD  - The Intensive Care Unit, Jerusalem, Israel; The Shaare Zedek Medical Center, 
      Hebrew University Faculty of Medicine, Samuel Byte 12, Jerusalem, Israel. 
      Electronic address: einav_s@szmc.org.il.
LA  - eng
PT  - Journal Article
DEP - 20230119
PL  - United States
TA  - Acad Radiol
JT  - Academic radiology
JID - 9440159
SB  - IM
PMC - PMC10035816
OTO - NOTNLM
OT  - ARDS
OT  - COVID-19 lung disease
OT  - Dual-energy computed tomography
OT  - aeration-blood-volume ratio
OT  - lung aeration
OT  - pulmonary blood volume
COIS- Declaration of Competing Interest None.
EDAT- 2023/03/26 06:00
MHDA- 2023/03/26 06:00
PMCR- 2023/01/19
CRDT- 2023/03/25 23:05
PHST- 2022/08/21 00:00 [received]
PHST- 2023/01/12 00:00 [revised]
PHST- 2023/01/13 00:00 [accepted]
PHST- 2023/03/26 06:00 [pubmed]
PHST- 2023/03/26 06:00 [medline]
PHST- 2023/03/25 23:05 [entrez]
PHST- 2023/01/19 00:00 [pmc-release]
AID - S1076-6332(23)00032-6 [pii]
AID - 10.1016/j.acra.2023.01.016 [doi]
PST - ppublish
SO  - Acad Radiol. 2023 Nov;30(11):2548-2556. doi: 10.1016/j.acra.2023.01.016. Epub 
      2023 Jan 19.